Clinical Prediction Model of Jonkman et al for Functional Decline in an Older Adult

Description

Jonkman et al reported a clinical prediction model for functional decline in an older adult. This can help to identify an older patient who may benefit from interventions to support activities of daily living (ADL). The authors are from multiple institutions in Europe and Australia.

Patient selection: age 65 to 75 years, without functional disability

Outcome: functional decline over the next 3 years

Parameters:

(1) patient population

(2) age in years

(3) cardiovascular disease

(4) diabetes mellitus

(5) COPD

(6) arthritis

(7) depressive symptoms (depression)

(8) body mass index (BMI) in kg per sq meter

(9) handgrip strength in kilograms

(10) gait speed Z-score

(11) number of seconds to complete 5 repeated chair stands

(12) converted value for 5 repeated chair stands

converted value for 5 repeated chair stands =

= MAX(0,X/46.24)

X =

= (((seconds)-7.73)^3) - (1.73 * ((seconds)-10.6)^3) + (0.73 * ((seconds)-14.53)^3)

Parameter	Finding	Points
population	British	4
	Dutch	1
	German	4
	Italian	0
age in years	65	0
	66	1
	67	2
	68	3
	69	4
	70	5
	71	6
	72	7
	73	8
	74	9
	75	10
cardiovascular disease	no	0
	yes	7
diabetes mellitus	no	0
	yes	6
COPD	no	0
	yes	11
arthritis	no	0
	yes	5
depressive symptoms	no	0
	yes	10
body mass index	< 25	0
	25 to 29.99	7
	>= 30	16
handgrip strength	<= 20 kg	7
	20.01 to 30 kg	5
	30.01 to 40 kg	3
	> 40 kg	0
Z-score gait speed	< -1.50	17
	-1.50 to -0.51	13
	-0.40 to 0.49	9
	0.50 to 1.5	5
	> 1.5	0
chair stand time	<= 10.7 seconds	0
	10.71 to 12.9 seconds	7
	> 12.9 seconds	17
converted time for chair stands	< 0.485	7
	0.485 to 2.091	6
	> 2.091	0

total score =

= SUM(points for all of the parameters)

Interpretation:

• minimum score: 0

• maximum score: 117

• The higher the score the greater the risk of functional decline.

Total Score	Percentage Decline
0 to 10	0%
11 to 20	0%
21 to 30	2%
31 to 40	6%
41 to 50	10%
51 to 60	18%
61 to 70	31%
71 to 80	47%
81 to 90	64%
> 90	82%

from Figure 2

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Clinical Prediction Model of Jonkman et al for Functional Decline in an Older Adult

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